P-249 - Somatic Screening in Psychiatric Out-patients: Additional Value of the Physical Examination

Abstract

Introduction:

It is a well-known fact that psychiatric in-patients often suffer from severe somatic problems, like diabetes mellitus or cardiovascular disease. Risk factors for somatic problems are frequently found, like obesity and smoking. in the Netherlands there are no clear recommendations for a standard somatic screening of psychiatric out-patients. in 2008 a pilot study was performed by GGZ Breburg, to investigate whether performing a somatic screening discloses any unknown physical information. This study showed that at least one ‘aspect of somatic concern’ (ASC) was found in 79% of all included patients. 63% of these somatic problems were previously unknown. Somatic screening showed to be useful, but until now there are no clear guidelines or supportive instruments available.

Objectives and aims: the objective of this study was to investigate the additional value of physical examination in the process of the construction of a screener for somatic problems in new psychiatric out-patients.

Methods:

Newly referred out-patients (n = 70) were somatically screened by a screening questionnaire and additional medical interview, laboratory examination and physical examination. When a somatic problem found, was previously unknown, the patient was referred to the general practitioner or a medical specialist.

Results:

At least one ASC was found in 81,4% of all patients. in 45,7% of all patients this somatic problem was newly found. 12% of all newly found somatic problems were solely found by physical examination.

Conclusions:

Physical examination creates substantial additive information in the somatic screening of psychiatric out-patients.